颅内体积和脑体积对急性缺血性卒中计算机断层扫描灌注核心体积预后价值的影响。
Impact of Intracranial Volume and Brain Volume on the Prognostic Value of Computed Tomography Perfusion Core Volume in Acute Ischemic Stroke.
作者信息
Hoving Jan W, Konduri Praneeta R, Tolhuisen Manon L, Koopman Miou S, van Voorst Henk, Van Poppel Laura M, Daems Jasper D, van Es Adriaan C G M, van Walderveen Marianne A A, Lingsma Hester F, Dippel Diederik W J, Van Zwam Wim H, Marquering Henk A, Majoie Charles B L M, Emmer Bart J
机构信息
Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
Department of Biomedical Engineering and Physics, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
出版信息
J Cardiovasc Dev Dis. 2024 Feb 28;11(3):80. doi: 10.3390/jcdd11030080.
BACKGROUND
Computed tomography perfusion (CTP)-estimated core volume is associated with functional outcomes in acute ischemic stroke. This relationship might differ among patients, depending on brain volume.
MATERIALS AND METHODS
We retrospectively included patients from the MR CLEAN Registry. Cerebrospinal fluid (CSF) and intracranial volume (ICV) were automatically segmented on NCCT. We defined the proportion of the ICV and total brain volume (TBV) affected by the ischemic core as ICV and TBV. Associations between the core volume, ICV, TBV, and functional outcome are reported per interquartile range (IQR). We calculated the area under the curve (AUC) to assess diagnostic accuracy.
RESULTS
In 200 patients, the median core volume was 13 (5-41) mL. Median ICV and TBV were 1377 (1283-1456) mL and 1108 (1020-1197) mL. Median ICV and TBV were 0.9 (0.4-2.8)% and 1.7 (0.5-3.6)%. Core volume (acOR per IQR 0.48 [95%CI 0.33-0.69]), ICV (acOR per IQR 0.50 [95%CI 0.35-0.69]), and TBV (acOR per IQR 0.41 95%CI 0.33-0.67]) showed a lower likelihood of achieving improved functional outcomes after 90 days. The AUC was 0.80 for the prediction of functional independence at 90 days for the CTP-estimated core volume, the ICV, and the TBV.
CONCLUSION
Correcting the CTP-estimated core volume for the intracranial or total brain volume did not improve the association with functional outcomes in patients who underwent EVT.
背景
计算机断层扫描灌注（CTP）估计的核心体积与急性缺血性卒中的功能结局相关。这种关系在患者中可能因脑容量而异。
材料与方法
我们回顾性纳入了MR CLEAN注册研究中的患者。在非增强CT（NCCT）上自动分割脑脊液（CSF）和颅内体积（ICV）。我们将受缺血核心影响的ICV和全脑体积（TBV）的比例定义为ICV和TBV。按四分位数间距（IQR）报告核心体积、ICV、TBV与功能结局之间的关联。我们计算曲线下面积（AUC）以评估诊断准确性。
结果
200例患者中，核心体积中位数为13（5 - 41）mL。ICV和TBV中位数分别为1377（1283 - 1456）mL和1108（1020 - 1197）mL。ICV和TBV中位数分别为0.9（0.4 - 2.8）%和1.7（0.5 - 3.6）%。核心体积（每IQR的校正比值比[acOR]为0.48[95%置信区间0.33 - 0.69]）、ICV（每IQR的acOR为0.50[95%置信区间0.35 - 0.69]）和TBV（每IQR的acOR为0.41[95%置信区间0.33 - 0.67]）显示90天后实现功能改善结局的可能性较低。CTP估计的核心体积、ICV和TBV在预测90天时功能独立方面的AUC为0.80。
结论
对颅内或全脑体积校正CTP估计的核心体积，并未改善接受血管内治疗（EVT）患者的功能结局相关性。
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